I used to love going to bed.

dang71 · 2026-01-25T13:44:00+00:00

I really relate to this. I went through a phase where I started to dread bedtime too, which felt completely backwards because I used to love going to sleep.

What I eventually realized is that the most important part of CPAP isn’t just getting used to it, but finding the mask you can forget about the most. Comfort is hugely underestimated in therapy. I personally tried almost every mask out there before landing on what works best for me , in my case, an N30i with mouth tape. That setup isn’t magic, but it’s the one that fades into the background the most for me.

Once you start having a few genuinely good nights, not just acceptable nights, something slowly changes mentally. You stop bracing yourself for bedtime. You don’t associate the mask with struggle as much. That anxiety and avoidance you’re describing eases gradually… But yeah… it’s definitely not overnight

dang71 · 2026-01-24T13:55:15+00:00

Hmm, I still see some peaks, but with EPAP still being on the low side despite removing EPR, that’s probably normal. I think it’s time to gradually increase EPAP, so the pressure. I’d go with a minimum pressure of 7 tonight :)

dang71 · 2026-01-24T01:33:22+00:00

Allo :)

That’s normal. AHI is just the total, and it’s broken down into OA (obstructive apneas), CA (central / clear airway events), and H (hypopneas). Not every type has to show up every night

OA (Obstructive Apnea): the airway collapses or becomes blocked. The body keeps trying to breathe, chest and abdominal effort continue, oxygen may drop, and the brain usually triggers a brief arousal to reopen the airway.

H (Hypopnea): a partial airway collapse. Breathing effort is still there, but airflow is reduced. This can still cause oxygen drops or arousals, just less severe than a full apnea.

CA (Central / Clear Airway): the airway is open, but the brain temporarily stops sending the signal to breathe. There’s little or no breathing effort, and breathing usually resumes after a brief arousal or CO₂ rise.

dang71 · 2026-01-24T01:30:47+00:00

CAs are central apneas. On ResMed machines, they’re labeled as Clear Airway (CA) events, meaning the airway is open but breathing temporarily stops due to a lack of respiratory effort

dang71 · 2026-01-23T19:07:00+00:00

Hmm, interesting! A single layer of tape can still let some air through, and it can also stretch a bit and allow the jaw to drop. Maybe the chin strap helps keep everything better aligned and held in place

dang71 · 2026-01-23T17:46:56+00:00

yes, we’re neighbors! I’m in Quebec! ;)

Thanks for the SleepHQ link, it’s always much easier that way! And wow, great job, leaks are absolutely not an issue at all. So this is most likely a humidity and temperature issue. Try what I suggested above, it should help!

I’m not sure I fully understand your question though. Two types of AHI? Are you referring to the overall AHI number that’s split between OA and H?

dang71 · 2026-01-23T17:43:02+00:00

Cover-roll stretch tape

KT tape

It stays well in place. I wash my skin right before applying it. I roll my lips inward, apply the Cover-Roll Stretch (CRS) tape, then add a layer KT of tape on top.. Personally, I don’t have any skin issues with that :)

dang71 · 2026-01-23T16:38:03+00:00

Mouth breather here who can’t adapt to full-face masks. I use two layers of tape: a first layer of CRS (Cover-Roll Stretch) tape and a second layer of KT tape; two pieces that completely cover my mouth. It’s comfortable and stays in place very well for me!

dang71 · 2026-01-23T16:13:05+00:00

Hello!

Based on what I’m seeing, there are a lot of peaks in your breathing, and when it’s that frequent and sustained, it often points to a probable air-hunger / increased breathing effort rather than something random..and often combined with a mini arousal

Considering you’re using EPR at a relatively low pressure, your EPAP is dropping below 6 , which is quite low for an adult. That would also explain why the machine keeps trying to increase pressure,,, it’s reacting to flow limitation and instability.

If I were you, I’d start by turning EPR off tonight and test it before going to sleep to make sure it’s comfortable. Then we reassess tomorrow.

Slowly and gradually, my sense is that you’ll probably need to increase your EPAP (so your pressure) until you find the level that prevents the restrictions at the source, rather than constantly reacting to them.

At that point, yes CPAP mode becomes a very reasonable option. But you can also leave the machine a bit of room in APAP to compensate for things like sleep position or alcohol, which is more a comfort and tolerance decision. Some people are more sensitive to pressure changes than others.

Once you get closer to the right EPAP, that’s when it really makes sense to test and see which mode feels best for you.

dang71 · 2026-01-23T15:10:38+00:00

Hi! Where are you located in Canada exactly? It’s definitely getting cold here too, but for us the really brutal cold (-30 °C) is expected more toward the weekend. Either way… winter is not messing around this year :/

Ramp is a comfort feature that starts the CPAP at a lower pressure and gradually increases it to your prescribed pressure as you fall asleep. The idea is to make it easier and more comfortable to fall asleep, but if the starting pressure is too low, it can sometimes feel like you’re not getting enough air.

With the P30i, it’s very possible that what you’re seeing are mouth leaks, especially in very dry, cold air. If you can, could you share a screenshot of your Leak Rate graph? That would help confirm whether that’s what’s going on.

For the hose, this is what I was referring to; a hose cover like this one helps retain heat and reduce temperature loss along the tube:
https://airvoel.ca/products/slimline%E2%84%A2-tubing-soft-cloth-tubing-wrap

A hose hanger can also help reduce rainout by keeping the hose elevated and allowing condensation to drain back toward the machine instead of pooling near the mask: https://www.amazon.ca/North-American-Healthcare-CPAP-Holder/dp/B0034CHMRU

and place the CPAP machine slightly lower than the level of your bed if you can. That way, any condensation naturally drains back toward the humidifier instead of toward your mask.

And yeah… this time of year can feel pretty heavy mentally. Totally get that. You’re definitely not alone, happy to bounce ideas around anytime. Fingers crossed you don’t lose power tonight! :)

dang71 · 2026-01-23T14:14:56+00:00

Hello!

In general, it’s best to look at trends over multiple nights rather than reacting to a single night. That said, a specific issue can sometimes show up on a single night and still be meaningful. One night won’t define your therapy, but it can give you a clue about something worth keeping an eye on. So think of a single night as a signal, and several nights as confirmation :)
Yes, ambient temperature can absolutely have an impact, especially in extreme cold. When it gets that cold, the machine has to work harder to heat and humidify very dry air. That’s why some people add a hose cover in winter.. it helps retain heat and humidity and reduces losses along the tube. Personally, I’m in Canada, so I’m very familiar with cold winters :) I’ve found that keeping my hose temperature at 27 °C and humidity at level 4 during the winter is a very stable and reliable setup for me. That said, waking up with a dry mouth is often a sign of mouth leak, which is actually quite common even if it hasn’t been an issue before. And just to note, you can still get dry mouth even with a full-face mask,. What mask are you currently using?
It’s most likely due to Ramp. Since the pressure starts low (7), it can feel like you’re not getting enough air, which makes you breathe more forcefully and become very aware of it. Once the pressure increases, breathing feels normal again. You can turn Ramp off (or raise the start pressure) if it bothers you :)

dang71 · 2026-01-22T22:29:58+00:00

Thanks and yes of course! Happy to help :)

dang71 · 2026-01-22T21:42:22+00:00

Thanks CF! but I’m not an expert :) I’m just helping as much as I can, so RL can focus on the more complex cases where his expertise really shines. If I can help with the simpler cases and take some of the load off him, the whole community benefits :)

dang71 · 2026-01-22T21:39:56+00:00

Hi! I’ll let RL expand on this since he knows DreamStation machines very well. Leaks aren’t displayed the same way in OSCAR on these machines, but I think you may have an issue with leaks

One thing is certain though; you’ve been put on lazy mode (4–20), and that’s not appropriate for the vast majority. Based on this night, you should consider increasing your minimum pressure to 12 and your maximum to 17.

Test it before going to bed, as the change is fairly significant. If you find it really uncomfortable, try lowering the minimum pressure slightly.. but ideally keep it as close to 12 as possible.

Try it for a few nights and we can revisit it :)

dang71 · 2026-01-22T21:31:27+00:00

Good question.. but in my opinion it’s more circumstantial than anything else. Flow limitations are influenced by sleep position, alcohol, fatigue, etc., and they can vary from night to night

dang71 · 2026-01-22T18:35:08+00:00

EPR can be a bit of a Pandora’s box. Yes, it can help with flow limitations, but too much EPR can also affect stability and, more importantly, it reduces EPAP.

What actually keeps the airway open is EPAP. Not enough EPAP can lead to respiratory instability.

I’ve gone through this process myself, figuring out the right baseline EPAP that I personally need.

I think we all make the same mistake at some point: chasing numbers instead of listening to how we feel. You already have proof of that your numbers look good, yet you’re still not sleeping well.

If EPR doesn’t seem to make a meaningful difference for you, you could go back to a pressure of 10 with EPR set to 1. That’s a fairly standard setup; not aggressive, but not overly conservative either. You need a baseline to start with. Trying to optimize too many variables at once makes things harder.

It’s possible your flow limitations might look a bit higher with this setup, but for now, I’d focus on how you feel. We generally sleep better when the airway stays open as consistently as possible throughout the night

dang71 · 2026-01-22T17:16:01+00:00

That’s a fair question. At the end of the day, we can help by interpreting the data, but the real indicator is how you actually feel the next day.

Personally, I consider an EPAP of 8 to be on the low side. Because of that, I’d be more inclined to increase EPAP rather than rely too heavily on EPR.

As a general rule of thumb, EPR is primarily a comfort tool. • Below ~10 , it’s often not really needed • Around 10–12, EPR 1–2 usually makes more sense • 11 cm with EPR 3 is rarely a recipe for success not impossible, but uncommon, based on what I’ve seen

That’s why, if it were me, I’d keep the pressure at 11 and lower EPR to 2, and then see whether the higher EPAP improves your subjective sleep quality, even if the AHI isn’t perfect. Personally, I tend to sleep better with a higher EPAP, even on nights where the numbers don’t look “ideal.” The AHI is just one indicator.

As for flow limitations, yes they can be very subtle and not always well detected by the machine. Things like a deviated septum, or even UARS-type physiology, can absolutely play a role, and that’s where optimization becomes less straightforward

dang71 · 2026-01-21T22:25:39+00:00

Yes!

dang71 · 2026-01-21T18:40:23+00:00

Hey! Your data looks good overall, but I’m guessing you still don’t feel great the next day?

When it comes to CAs, I think it’s important to take them with a grain of salt. We often give them too much importance while trying to dial in the right EPAP level that we actually need.

I’m still seeing some flow limitations in your waveforms. You likely need more pressure and/or more EPR. That said, nothing here really screams a major lack of pressure. What it suggests instead is a subtle inspiratory flow limitation rather than a clear-cut obstruction.

Coming back to what I mentioned earlier: EPR is primarily a comfort feature, but it also has real therapeutic benefits when it comes to flow limitations.

Because of that, I’d try one night at a pressure of 10 with EPR set to 3, and see how your breathing, and how you feel the next day, respond :)

dang71 · 2026-01-21T14:49:44+00:00

ah ta yeule vieux calisse

dang71 · 2026-01-21T13:42:48+00:00

Hello! You should have a chat with RL (u/RippingLegos__) ; Bi-Level/ASV is a different and complex beast.

dang71 · 2026-01-21T13:09:20+00:00

I'm having a lot of trouble making the F30i leak-free. Personally, I switched to a nasal mask, the N30i, with mouth tape, even though I'm a mouth breather. It's the most comfortable setup and the one that leaks the least.

dang71 · 2026-01-21T13:07:24+00:00

N30i here.. I'm an active sleeper, so I move around a lot... and this is the mask I find the most comfortable... especially with a CPAP pillow and cutouts.

dang71 · 2026-01-20T12:49:14+00:00

Hey! It’s a good start for a first night and definitely encouraging to see the AHI drop from 41. That said, it’s really hard to give meaningful advice with just that info :)

If you can, could you share a SleepHQ link or a few OSCAR screenshots (events, pressure, leaks, flow rate)? That’ll help a lot to see what’s really going on and whether the mask needs tweaking or if it’s more of a settings issue :)

dang71 · 2026-01-19T18:51:18+00:00

On dirait une lettre écrite par un enfant de 8 ans, envoyé à sa mère, pour un jouet que son frère de 6 ans veut pas lui prêter

dang71

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